2 area hospitals say smokers need not apply

Sunday

Feb 24, 2013 at 6:00 AMMar 1, 2013 at 11:17 AM

By Geraldine A. Collier CORRESPONDENT

With a pack of cigarettes costing up to $8.50, smokers already pay a hefty price to light up. But they might find that nicotine rush costing them even more if they want a job in the Massachusetts health care field.

Several Massachusetts hospitals — including two in Central Massachusetts — will no longer hire job applicants if they smoke or use tobacco products.

Health care providers say they cannot speak with any authority on healthy lifestyles if they continue to tolerate smoking among their own employees, as smoking is a major cause of preventable diseases in the U.S.

“If you're going to talk the talk, then you have to walk the walk,” said Lynn Nicholas, president and chief executive officer of the Massachusetts Hospital Association, which hung out the no-smokers-need-apply sign two years ago.

“I took some flak, but it was the right thing to do,” said Ms. Nicholas.

Following the path blazed by the MHA, Heywood Hospital in Gardner, owned by North Central Healthcare, established the change in hiring policy Oct. 1. St. Vincent Hospital and MetroWest Medical Center, both owned by Vanguard Health Systems of Nashville, came on board Nov. 1. They join Cooley Dickinson Hospital in Northampton and Anna Jaques Hospital in Newburyport.

“The north central area of the state has one of the highest smoking rates in the state,” said Winfield “Win” Brown, president and chief executive officer of North Central Healthcare. “We have to step up and make a statement about that, and be a leader in the field.”

The no-hiring-smokers policy is not yet in effect at Athol Memorial Hospital, which, as of Jan. 1, merged with Heywood under the umbrella of North Central Healthcare. “We haven't brought that (policy) to Athol yet, but it does have a smoke-free campus,” said Mr. Brown.

About 71 percent of Massachusetts hospitals are smoke- or tobacco-free, according to Ms. Nicholas at the MHA. That means that staff and visitors as well as patients cannot smoke on hospital property.

The no-smokers-need-apply policy is just one more step in a continuing effort to stop tobacco use, according to Ms. Nicholas. “There is nothing beneficial, whatsoever, about tobacco use, other than to the tobacco industry,” she said.

The policy change does not affect employees already on the job before the start of the new hiring policy, although they will be expected not to use tobacco anywhere on hospital campuses.

Nor can they, at least in Worcester and Gardner, smoke on sidewalks or property near hospitals.

The Gardner Board of Health has created a 200-foot no-smoking buffer zone around Heywood, including an area at the foot of two driveways where hospital employees used to huddle to puff away — a much-discussed topic of conversation in the community, and a sore spot with the hospital's top administrator.

“Here I am, a public health leader, and I have all these people standing at the foot of our driveways — just technically off campus — smoking, right next to the 'no smoking' sign,” said Mr. Brown.

In Worcester, the City Council has established a 50-foot no-smoking buffer zone in front of the entrances and exits of Worcester Medical Center, according to Paul R. Strniste, vice president of facilities at St. Vincent Hospital.

While smoking rates among adults have dropped precipitously over the past decades, acknowledged Lisa Whaley, vice president of human resources for Vanguard Health Systems, “there is still 10 to 20 percent of the population, depending on the region, that still uses tobacco products.”

About 18.1 percent of adults in Massachusetts smoke, according to statistics from the 2011 Behavior Risk Factor Surveillance System produced by the Centers for Disease Control and Prevention. Other surveys show a slightly higher rate of smoking, about 18.2 percent, among high school and middle school youths in the state.

Ms. Whaley said Vanguard's new hiring policy prohibits hiring those individuals who not only smoke cigarettes or cigars or chew tobacco, but also those who wear a nicotine patch or chew nicotine gum. Use of the patch or gum could serve to mask tobacco use in a screening test.

“We are not trying to pry into people's lives, but we do want to encourage our employees to lead healthy lifestyles,” said Ms. Whaley.

For the past year, she said, Vanguard Health Systems has been establishing the new hiring policy in its Nashville-based home office as well as throughout all of its hospital facilities, with the exception of four hospitals owned by Vanguard in Illinois.

Illinois is among 29 states and the District of Columbia that have laws on the books that prohibit employers from either refusing to hire smokers or firing an employee for using any type of tobacco product during non-working hours and off the employer's property.

“Obviously, state law applies, so we can't implement (this policy) anywhere where it would be illegal,” said Ms. Whaley.

There are no laws on either the federal level or on the Massachusetts books that would prevent employers from refusing to hire smokers, according to Jonathan R. Sigel, a partner in the labor, employment and employee benefits group at Mirick O'Connell.

In fact, Massachusetts statutes that took effect Jan. 1, 1988, could set a precedent for Massachusetts employers. Those laws prohibit hiring smokers as uniformed state police; Department of Correction employees whose job duties require the care, supervision or custody of prisoners and criminally insane people; city or town police officers or firemen; and Registry of Motor Vehicles investigators or examiners empowered to perform police duties.

There are screening tests — blood, saliva or urine samplings — that can detect the use of tobacco products. The MHA, which has 46 employees, has been using the “honor system” for the past two years.

North Central Healthcare, with 1,000 employees, will also take the word of a prospective employee that he or she is tobacco-free, but if a job applicant is hired and then found to have been lying, he or she would be fired, according to Mr. Brown.

St. Vincent and MetroWest — the former Framingham Union Hospital and Leonard Morse Hospital in Natick — will use a urine test that will be sent out to an independent laboratory for analysis, according to Ms. Whaley.

If the test comes back positive, the job applicant will be encouraged to enroll in a community smoking cessation program and would be welcome to reapply for the job opening after 90 days.

According to Ms. Nicholas, the MHA is putting together new policy guidelines for hospitals and health care providers to use if they want to go forward with a policy of not hiring smokers.

The MHA's guidelines can also be a resource for businesses that might not want to hire smokers.

“If you can do this in a complex environment like a hospital — with shift work, a widely ethnically diverse work force, workers of all ages, workers undergoing a lot of stress — if you can do it there, you can do it anywhere,” said Ms. Nicholas.

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